Organization
MID-CITIES MEDICAL TRANSPORT
Active
Organization
MID-CITIES MEDICAL TRANSPORT
Active
Other names
C.V. Manimbo Enterprises Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CONRADO VILLASENOR MANIMBO (OPERATION MANAGER)
(714) 238-9005
Entity
Organization
Contact information
Practice address
1325 N RED GUM ST, # 14, ANAHEIM, CA 92806-1326
(714) 238-9005
(714) 238-9085
Mailing address
1325 N. RED GUM ST., # 14, ANAHEIM, CA 92806-1387
(714) 238-9005
(714) 238-9085
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MTN01213F
—
CA
Enumeration date
09/11/2012
Last updated
09/11/2012
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